94 articles - From Friday May 12 2023 to Friday May 19 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Am J Gastroenterol |
American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation. This document provides a comprehensive outline of the various over-the-counter and prescription pharmacological agents available for the treatment of CIC. The guidelines are meant to provide a framework for approaching the management of CIC; clinical providers should engage in shared decision making based on patient preferences as well as medication cost and availability. Limitations and gaps in the evidence are highlighted to help guide future research opportunities and enhance the care of patients with chronic constipation. |
| Hepatology |
meta-analyses and systematic reviews
| Gastrointest Endosc |
The impact of center and endoscopist ERCP volume on ERCP outcomes: a systematic review and meta-analysis. High-volume endoscopists and centers provide higher ERCP success rates with fewer overall adverse events, especially bleeding, compared to the respective low-volume comparators. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Trends in aetiology-based hospitalisation for cirrhosis before and during the COVID-19 pandemic in the United States. In-hospital mortality in cirrhosis was higher in the COVID-19 era than in the pre-COVID-19 era. ALD is the leading aetiology-specific cause of in-hospital mortality in cirrhosis with an independent detrimental impact of the COVID-19 infection. |
| Am J Gastroenterol |
Empiric esophageal dilatation for solid-food dysphagia: presence of mucosal tear on relook endoscopy predicts symptomatic response. Patients with a mucosal tear following empiric dilatation have a superior symptomatic response to those without, and comparable to patients with visible strictures. We infer the tear represents disruption of an endoscopically inapparent stricture. |
Microscopic colitis and risk of incident acute pancreatitis: A nationwide population-based matched cohort study. This nationwide study of more than 12,000 patients with MC demonstrated an increased risk of acute pancreatitis after MC. Hence, clinicians should have a low threshold for evaluation of acute pancreatitis in patients with MC. Also, these patients should receive advice and care aimed at reducing the risk of acute pancreatitis. |
| Clin Gastroenterol Hepatol |
Bile Acid Sequestrants in Microscopic Colitis: Clinical Outcomes and Utility of Bile Acid Testing. In one of the largest cohorts evaluating BAS treatment in MC, nearly two-thirds had a partial or complete response. Additional research is needed to determine the role of BAS and bile acid malabsorption in MC. |
Burden of Crohn's Disease in the United States Medicaid Population, 2010 - 2019. From 2010-2019, Medicaid population CD prevalence increased while incidence decreased from 2013-2019. Overall Medicaid CD incidence and prevalence ranges align with prior large administrative database studies. |
Real-World Experience with Tofacitinib Dose De-escalation in Patients with Moderate and Severe Ulcerative Colitis. In this real-world cohort, we observed a 56% cumulative incidence of UC events at 12 months in patients with tofacitinib dose de-escalation. Observed factors associated with UC events after dose de-escalation included induction course <16 weeks and active endoscopic disease 6 months after initiation. |
Secondary prevention of esophageal variceal bleeding is often imperfect: A national, population-based cohort study of 3,592 patients. Secondary prevention of esophageal variceal bleeding has not been widely undertaken, with many patients not receiving guideline-supported interventions within a reasonable timeframe. This highlights a need to raise awareness on appropriate prevention strategies to clinicians and patients. |
| Endosc Int Open |
Automatic textual description of colorectal polyp features: explainable artificial intelligence. CADx performance differed per CRP feature and was particularly high for surface descriptors while size and pits-distribution description need improvement. Explainable AI can help comprehend reasoning behind CADx diagnoses and therefore facilitate integration into clinical practice and increase trust in AI. |
Endoscopic calcium electroporation for colorectal cancer: a phase I study. This first study of calcium electroporation for colorectal tumors shows that calcium electroporation is a safe and feasible treatment modality for colorectal cancer. It can be performed as an outpatient treatment and may potentially be of great value for fragile patients with limited treatment options. |
Incomplete resection rates of 4- to 20-mm non-pedunculated colorectal polyps when using wide-field cold snare resection with routine submucosal injection. s Use of CSP-SI results in lower IRRs compared to what has previously been reported in the literature for hot or cold snare polypectomy when not using wide-field cold snare resection with submucosal injection. CSP-SI showed an excellent safety and efficacy profile, however comparative studies to CSP without SI are required to confirm these results. |
Low risk of new dysplastic lesions in an inflammatory bowel disease population study with dye chromoendoscopy. The risk of dysplasia progressing to advanced neoplasia and, specifically, the risk of new neoplastic lesions after endoscopic resection of colitis-associated dysplasia, are both very low. |
Multicenter prospective evaluation of an overtube endoluminal interventional platform for colorectal polypectomy. s Endoscopic colon polyp resection with the DBEP was safe with a high technical success rate. The DBEP has the potential to provide enhanced scope stability and visualization, traction, and a conduit for scope exchange. Further prospective randomized studies are warranted. |
Novel anti-reflux biliary metal stent with a distal tapered end for distal malignant biliary obstruction: a feasibility study. Endoscopic placement of the newly developed TMS in patients with DMBO is technically feasible and safe, and the TRBO was remarkably long. The anti-reflux mechanism based on the difference in diameter may be effective, and a randomized controlled trial with a conventional SEMS is required. |
| Endoscopy |
Colorectal cancer and advanced adenoma incidence during post-polypectomy surveillance: a national cohort study in the English Bowel Cancer Screening Programme. This large, national analysis found low levels of CRC in those undergoing surveillance and low advanced adenoma yield in most subgroups. Less intensive surveillance in some subgroups is warranted, and surveillance may be avoided in those with a single large adenoma. |
| Gastroenterology |
ALKBH5 Drives Immune Suppression via targeting AXIN2 to Promote Colorectal Cancer and is a Target for Boosting Immunotherapy. Our study identifies an ALKBH5-m 6 A-AXIN2-Wnt-DKK1 axis in CRC which drives immune suppression to facilitate tumorigenesis. Targeting of ALKBH5 is a promising strategy for sensitizing CRC to immunotherapy. |
Cancer in patients with familial adenomatous polyposis - a nationwide Danish cohort study with matched controls. Despite an absolute reduction in the risk of developing cancer among FAP patients, the risk remained significantly higher than for the background population due to colorectal, pancreatic, and duodenal/small bowel cancers. |
Elevated APE1 dysregulates homologous recombination and cell cycle driving genomic evolution, tumorigenesis and chemoresistance in esophageal adenocarcinoma. Elevated APE1 dysregulates HR and cell cycle contributing to genomic instability, tumorigenesis and chemoresistance, and its inhibitors have potential to target these processes in EAC and possibly other cancers. |
| Gastrointest Endosc |
| Gut |
Eradicating Helicobacter pylori via 13C-urea breath screening to prevent gastric cancer in indigenous communities: a population-based study and development of a family index-case method. Objective Screening and eradication of and an efficient rollout method indicate that a primary prevention strategy is acceptable and feasible in indigenous communities. |
Life cycle assessment of routinely used endoscopic instruments and simple intervention to reduce our environmental impact. Knowledge of carbon footprint is crucial to select the most sustainable alternatives because there are large variations between brands. A mark to identify recyclable parts could reduce our environmental impact significantly. |
Screening of normal endoscopic large bowel biopsies with interpretable graph learning: a retrospective study. The model achieved consistently high accuracy showing its potential in optimising increasingly scarce pathologist resources. Explainable predictions can guide pathologists in their diagnostic decision-making and help boost their confidence in the algorithm, paving the way for its future clinical adoption. |
Technical performance and diagnostic yield of motorised spiral enteroscopy compared with single-balloon enteroscopy in suspected Crohn's disease: a randomised controlled, open-label study (the MOTOR-CD trial). MSE and SBE have comparable technical success and diagnostic yield for small bowel evaluation in suspected CD. MSE scores over SBE with regard to deeper small bowel evaluation with complete small bowel coverage and higher depth of insertion in a shorter time. |
| Hepatology |
Antiviral therapy substantially reduces hepatocellular carcinoma risk in chronic Hepatitis B patients in the indeterminate phase. Antiviral therapy reduces HCC risk by 70% among indeterminate phase CHB patients. These data have important implications for the potential expansion of CHB treatment criteria. |
Current challenges and future perspectives in treating patients with NAFLD-related cirrhosis. We relied on the recommendations of the scientific societies and discussed them in the specific context of NAFLD cirrhosis and the surrounding cardiometabolic milieu. Here we covered the following aspects: (1) the weight loss strategies through lifestyle interventions to avoid sarcopenia and improve portal hypertension (PHT); (2) the optimal control of metabolic comorbidities in particular type 2 diabetes aimed to improve cardiovascular morbidity/mortality but also to lower the incidence of cirrhosis related complications; we discussed various aspects related to the safety of the oral antidiabetic drugs in cirrhosis; (3) the challenges in performing bariatric surgery in patients with cirrhosis related to the PHT and the risk of cirrhosis decompensation; (4) the particularities in the diagnosis and management of the PHT and the difficulties in managing patients awaiting for liver transplantation; we underlined (5) the difficulties to develop drug and to conduct clinical trials in patients with NAFLD-related cirrhosis and discussed the emerging options to overcome these obstacles. |
Etiological cure prevents further decompensation and mortality in cirrhotic patients with ascites as the single first decompensating event. In patients with cirrhosis and ascites as single first decompensating event, the cure of liver disease etiology represents a main treatment goal since this translates into considerably lower risks of further decompensation and mortality. |
Future directions in acute liver failure. To review ALFSG's accomplishments and consider next steps, a two-day in-person conference was held at UT Southwestern Medical Center, Dallas, Texas, entitled "Acute Liver Failure: Science and Practice," in May 2022. To summarize the important findings in the field, this review highlights the current state of understanding of ALF and, more importantly, asks what further studies are needed to improve our understanding of the pathogenesis, natural history, and management of this unique and dramatic condition. |
Progression of liver disease and portal hypertension in dyskeratosis congenita and related telomere biology disorders. Our experience shows a high prevalence of cholestatic pattern of liver abnormality with progression to portal hypertension in patients with DC/TBD. Presence of pulmonary and/or vascular disease in patients with recessive or TINF2 DC were important predictors of liver disease progression suggesting the need for increased vigilance and monitoring for complications in these patients. |
Soluble ORF2 protein enhances HEV replication and induces long-lasting antibody response and protective immunity in vivo. These findings indicate ORF2s may be dispensable for viral replication in vivo but is required for long-lived antibody-mediated responses that protect against HEV re-exposure. |
| J Hepatol |
RSK2 inactivation cooperates with AXIN1 inactivation or ß-catenin activation to promote hepatocarcinogenesis. Our study newly demonstrated the tumor suppressor role of RSK2 and its specific synergistic effect in hepatocarcinogenesis when its loss of function is specifically combined with AXIN1 inactivation or ß-catenin activation. Furthermore, we identified the RAS/MAPK pathway as a potential therapeutic target for RSK2-inactivated liver tumors. Impact and implications This study demonstrated the tumor suppressor role of RSK2 in the liver and showed that its inactivation specifically synergizes with AXIN1 inactivation or ß-catenin activation to promote the development of HCC with similar transcriptomic profiles as found in humans. Furthermore, this study highlights that activation of the RAS/MAPK pathway is one of the key signaling pathways mediating the oncogenic effect of RSK2 inactivation that can be targeted with already available anti-MEK therapies. |
| Neurogastroenterol Motil |
Enhanced neuron-glia network in the submucosa and increased neuron outgrowth into the mucosa are associated with distinctive expressions of neuronal factors in the colon of rat IBS model. Neuron network enhancement in the submucosa and neuron outgrowth into the mucosa may be associated with axon guidance factors expressed in hyperplastic EGCs in the colonic submucosa of IBS models. |
Proximal esophageal impedance baseline increases the yield of impedance-pH monitoring for GERD diagnosis and is associated with heartburn response to PPI. Impedance baseline assessment in the proximal esophagus may increase the diagnostic yield of impedance-pH monitoring. Heartburn response to PPI is directly related to ultrastructural mucosal damage in the distal and in the proximal esophagus as well. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| J Hepatol |
Changing epidemiology, global trends and implications for outcomes of NAFLD. This narrative review discusses recent changes in the epidemiology of NAFLD and NASH from regional and global perspectives, as well as in special populations. We also discuss the consequences these changes can have on hepatic and extra-hepatic events. |
Immunobiology of Cholangiocarcinoma. Broad strategies to re-equip the immune system include blockade of suppressive immune cell recruitment to priming cytotoxic effector cells against tumor antigens. While immunotherapeutic strategies are gaining traction in the treatment of cholangiocarcinoma, there is a long road of discovery ahead in order to make meaningful contributions to patient therapy and survival. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Endosc Int Open |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
| J Hepatol |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gut |
| J Hepatol |
| Neurogastroenterol Motil |